Provider Demographics
NPI:1407027675
Name:YAGALOFF, CAROLYN MICHELLE (LMFT)
Entity Type:Individual
Prefix:MS
First Name:CAROLYN
Middle Name:MICHELLE
Last Name:YAGALOFF
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:440 C NORTH MAIN STREET
Mailing Address - Street 2:THE COUNSELING CENTER
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-1902
Mailing Address - Country:US
Mailing Address - Phone:860-583-5858
Mailing Address - Fax:860-584-9962
Practice Address - Street 1:440 C NORTH MAIN STREET
Practice Address - Street 2:THE COUNSELING CENTER
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-1902
Practice Address - Country:US
Practice Address - Phone:860-583-5858
Practice Address - Fax:860-584-9962
Is Sole Proprietor?:No
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001169106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist